P-endorphin during clinical and experimental ischaemic pain. Scand J Clin Lab Invest 1987; 47: 751-758.An improved radio-immunoassay using an antiserum directed towards the N-terminal part of the endogenous opioid peptide f3-endorphin 1-31 (f3-EP) was validated and applied to a study of P-EP in plasma during ischaemic pain. Experimental ischaemic pain induced in seven healthy volunteers by the submaximal effort tourniquet test did not change plasma P-EP or adrenocorticotrophin. Plasma P-EP was determined in 21 patients with acute myocardial infarction (AMI) and in seven patients with unstable angina pectoris. Plasma P-EP was 4.9 fmoVml with 95% confidence limits, 3.2-7.8 fmol/ml in AM1 patients at admittance, and 2.9 (2.G3.4) fmoUml one week later in stable and pain-free condition (p<0.05). The level in 49 healthy persons was 2.8 (2.4-2.9) fmol/ml. Elevated P-EP levels were found in five AM1 patients with cardiogenic shock and in four AM1 patients dying within 24 h after admittance compared to the rest of AM1 patients (p<0.02). P-EP was not elevated during unstable angina pectoris, although pain scores were similar to AMI. The AM1 group revealed a significant, although weak, positive correlation between plasma P-EP and pain score (Spearman r=0.49. p<0.05), while there was no correlation during unstable angina pectoris. P-EP was not correlated to the amount of morphine required within the 48 h after admittance of AM1 patients. We conclude that the increase of p-EP in plasma during AM1 may be due to stressful factors other than ischaemic pain and that it is questionable whether p-EP in plasma is related to antinociception.The 31 amino acid residue peptide, Panalgetic properties when tested in biological endorphin (P-EP), characterized by potent assays [l], is cleaved from the 31 kDa common 75 1 Scand J Clin Lab Invest Downloaded from informahealthcare.com by McMaster University on 11/18/14 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by McMaster University on 11/18/14 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by McMaster University on 11/18/14 For personal use only.